Competing discourses as barriers to change in rehabilitation nursing: a discourse analysis.
Sanne Angel, Randi Steensgaard, Raymond Kolbaek and 1 others
PMID 38149111WHAT IT FOUND
Nurses in a spinal cord injury unit described patient dialogue as central to participation, but tight task routines left little time.
The analysis found a dominant biomedical task culture that blocked time for dialogue.
Key findings
01Nurses described patient-nurse dialogue as central to understanding the patient and building a cooperative relationship.
02They said patient participation needed time and space, but routines required finishing practical tasks and preparing patients for training.
03The analysis found competing biomedical and biopsychosocial discourses, with the biomedical task culture dominating how rehabilitation was prioritized.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The data came from nurses in one Danish spinal cord injury unit, so the findings may not apply to other settings or professions. It is a follow-up analysis of an action research project, not a study that measured patient outcomes or compared treatments. The paper reports nurses' language and experience, not patients' own accounts, so patient participation is described indirectly. Discourse analysis is interpretive, so the way the barriers are framed may not be the only reading of the data.
Declared interests
The authors declare that no financial support was received for the research, authorship, or publication.
The easy way to misread this
Do not read this as evidence that nurse dialogue improves spinal cord injury recovery. It is a qualitative analysis of nurses' experience in one unit and does not test patient outcomes.